Original article

Clinical study on endoscopic injection of tissue adhesive with hardener in treatment of gastric varices and follow-up

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  • Department of Gastroenterology, Ruijin Hospital (North), Shanghai Jiao Tong University School of Medicine, Shanghai 201801, China

Received date: 2020-08-14

  Online published: 2022-11-10

Abstract

Objective To analyze the therapeutic effect of endoscopic injection of tissue adhesive combined with hardener for the portal hypertensive patients with gastric varicose and prognosis. Methods A total of 84 patients with upper gastrointestinal hemorrhage and gastric varices diagnosed by gastroscopy during 2006 to 2015, who were performed endoscopic injection with tissue adhesive with hardener, were included in this study. The rate of gastric hemorrhage was compared before and after endoscopic treatment. The rate of gastric varices elimination and the prognosis were analyzed. Results There were 111 times of endoscopic treatment for 84 cases with an average of(1.32±0.68) times per case. Bleeding was (0.72±0.54) times/month before treatment and (0.30±0.82) times/month after treatment respectively with significant difference statistically(P<0.01). The eradication rate of varicose veins with almost disappearance was 75.0% during the period of 6 months post endoscopic treatment and 70.8% after 6 months of endoscopic treatment. No re-bleeding was found without any complications, ectopic embolization and infection after follow-up of (14.82±19.30) months. Conclusions Endosco-pic injection of tissue adhesive and hardener for gastric varices would reduce the rate of bleeding of gastric varicose and the varicose vein, which was an important procedure for prevention of re-bleeding of gastric varicose vein and could be applied clinically.

Cite this article

ZHANG Mengyin, CHEN Ping, YUAN Xiaoqin, CAI Boer, WU Yunlin . Clinical study on endoscopic injection of tissue adhesive with hardener in treatment of gastric varices and follow-up[J]. Journal of Surgery Concepts & Practice, 2022 , 27(05) : 443 -447 . DOI: 10.16139/j.1007-9610.2022.05.012

References

[1] 中华医学会外科学分会门静脉高压症学组. 肝硬化门静脉高压症食管、胃底静脉曲张破裂出血诊治专家共识(2015)[J]. 中国实用外科杂志, 2015, 35(10):1086-1090.
[2] Mishra SR, Chander Sharma B, Kumar A, et al. Endoscopic cyanoacrylate injection versus beta-blocker for secondary prophylaxis of gastric variceal bleed: a randomised controlled trial[J]. Gut, 2010, 59(6):729-735.
[3] 中华医学会消化内镜学分会食管胃静脉曲张学组. 消化道静脉曲张及出血的内镜诊断和治疗规范试行方案(2009年)[J]. 中华消化内镜杂志, 2010, 27(1):1-4.
[4] 吴巍, 陈舒, 陶凤来, 等. 胃静脉曲张内镜下黏合剂栓塞治疗后排胶与再发出血的关联[J]. 中华消化病与影像杂志(电子版), 2018, 8(6):257-260.
[5] 吴志勇, 陈炜. 肝硬化门静脉高压症术式的合理选择[J]. 外科理论与实践, 2012, 17(6):604-606.
[6] 中华医学会消化病学分会, 中华医学会肝病学分会, 中华医学会内镜学分会. 肝硬化门静脉高压食管胃静脉曲张出血的防治共识(2008, 杭州)[J]. 中华消化杂志, 2008, 28(8):551-558.
[7] Nett A, Binmoeller KF. Endoscopic management of portal hypertension-related bleeding[J]. Gastrointest Endosc Clin N Am, 2019, 29(2):321-337.
[8] Fujii-Lau LL, Law R, Wong Kee Song LM, et al. Endoscopic ultrasound(EUS)-guided coil injection therapy of esophagogastricand and ectopic varices[J]. Surg Endosc, 2016, 30(4):1396-1404.
[9] 朱伟华, 蒋海根, 刘江. 金属夹在食管胃曲张静脉出血内镜治疗困难病例即时止血中的应用[J]. 中华肝脏病杂志, 2020, 28(3):266-268.
[10] Martins RD, Szejnfeld J, Lima FG, et al. Endoscopic ultrasonographic, and US-Doppler parameters as indicators of variceal bleeding in patients with schistosomiasis[J]. Dig Dis Sci, 2000, 45(5):1013-1018.
[11] Xiaoqing Z, Na L, Lili M, et al. Endoscopic cyanoacrylate injection with lauromacrogol for gastric varices: long-term outcomes and predictors in a retrospective cohort study[J]. J Laparoendosc Adv Surg Tech A, 2019, 29(9):1135-1143.
[12] Hashizume M, Akahoshi T, Tomikawa M. Management of gastric varices[J]. J Gastroenterol Hepatol, 2011, 26 Suppl 1:102-108.
[13] 王燕颖, 禹晶, 张秉全. 肝硬化门静脉高压症食管胃静脉曲张的内镜诊断和治疗[J]. 中国临床医生, 2013, 41(8):3-5.
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